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Mr. Bush Goes to Washington

by Jonathan Bush, President & CEO

You can’t believe the play that little athenahealth gets in Washington, DC… and thank goodness for it because no one has a clue about HIT.

How could they really?

I mean, there are 535 people in our federal legislature (give or take) and there are like a million different market spaces in the nation. This is why I have such a hard time with federal control of things. It’s impossible for them to  know what’s going on…there are just not enough hours in the year.

As I’ve been thinking about care coordination and the complete lack of sustainable models or entrepreneurship in that space, it occurred to me that it's currently not clear that it is legal for RECEIVERS of electronic health information to pay senders for the value of that health information. This means that the sender has no real motivation to send useful, relevant data in a timely manner (I know I'd pay the doc who sent me exactly what I needed about a patient more than I'd pay the doc who sends over a 30-page PDF) and that our industry will take a long time to understand the true health information exchange needs of providers.

I wanted to bring the concept with me to the Hill that Meaningful Use, in my opinion, is use that is meaningful to a medical care provider in the actual doing of business. In a space with such clear demand, we’ve got to let innovators develop a way to supply information that the market (providers of care) needs, if we want to improve outcomes and reduce costs.

So I flew down to Washington and it was tons of fun… me and Lauren Fifield and the lobbyist and a full dance card on Capitol Hill.

First, we met with Sally Canfield, policy director for Sen. Marco Rubio, R-Fla.

She’s a true health policy veteran who likes getting—and will give you—the straight story. She’s also one of the only people on the Hill with whom I could speak at my normal (lightning) pace and know she can keep up. We talked about everything from the potential fall of hospitals (Need a hospital?  Just scan the horizon for a construction crane)...to the alarming rate of physician employment...to making Meaningful Use really meaningful...to encouraging care coordination…to life in the cloud.

Then we met with Rep. Tom Price, R-Ga. Since he’s a physician, he has great insights into the medical world given his years of practice.

We talked about:

  • Enabling care coordination through innovation and entrepreneurship
  • Defining Meaningful Use as helping doctors exchange meaningful data
  • Using the data to improve outcomes and patient care, at the point of care

Next was Sen. Johnny Isakson, R-Ga. Another Johnny! And a nice guy to boot.

We talked about:

  • Our new office in Georgia and our recent acquisition of Proxsys, which is now known as athenaCoordinator
  • The Meaningful Use dashboard, how athenahealth has been promoting transparency and using data to make Meaningful Use meaningful
  • A potential location idea for our expanding Georgia office!

Around lunchtime that day we met with Rep. Chellie Pingree, D-Me. She’s my neighbor up in Maine.

We talked about:

  • The Maine health care ecosystem
  • The cloud model for health information
  • Dollars from secondary payers currently being left on the table by the Defense Department and the VA
  • The Meaningful Use Dashboard

In the early afternoon, we met with Rep. Paul Ryan, R-Wis. You’ve probably heard of him and he’s already made his mark as a thought leader who strongly believes in the free market. 

We talked about:

  • The need to develop technology structures that do not allow for “silo-ed” information
  • The potential that Meaningful Use could be meaningless if we continue to delay timelines and accept exchange requirements that do not foster the actual exchange of meaningful data
  • Pushing for data usage and transparency in the MU program, as seen in The Meaningful Use Dashboard
  • The relatively low amount of venture capital in health care and the need for an economically sustainable model of information exchange

Then we walked to the Capitol building with Rep. Diane Black, R-Tenn. She’s a former nurse who has been an active member, and vocal in the HIT space.

We talked about:

After a mid-afternoon conference call, we went over to the Senate side and met up with Sen. Mike Enzi, R-Wyo., and then Sen. Scott Brown, R-Mass., to talk about the market-driven, and therefore sustainable, approach to care coordination.  And, as always, it was a pleasure to see Sen. Susan Collins, R-Me. We talked about the job opportunities athenahealth has been creating in Maine and happenings at Point Lookout. We also talked about making Meaningful Use meaningful and letting the program run without further delays or watered-down measures to ensure that only providers demonstrating MEANINGFUL use would receive payments. We also touched on care coordination and the need to let entrepreneurs and innovation drive us.

So you may be asking…why are we doing this? What is the benefit?

If you do ask, I’ll answer.

Jonathan Bush is the President and CEO of athenahealth.

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